Stomach Cancer (Gastric Carcinoma): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; furthermore:
    • Inspection (viewing).
      • Skin, mucous membranes and sclerae (white part of the eye) [In advanced stages, the following symptom may occur: Icterus (jaundice)]
      • Abdomen (abdomen)
        • Shape of the abdomen?
        • Skin color? Skin texture?
        • Efflorescences (skin changes)?
        • Pulsations? Bowel movements?
        • Visible vessels?
        • Scars? Hernias (fractures)?
    • Inspection and palpation (palpation) of the lymph node stations (cervical, axillary, supraclavicular, inguinal); lymph node involvement of the Virchow’s gland (= supraclavicular lymph node station left) (absolute rarity).
    • Inspection and palpation of the spine.
    • Auscultation (listening) of the heart
    • Auscultation of the lungs
    • Examination of the abdomen (belly)
      • Percussion of the abdomen/examination of the abdominal cavity by tapping the abdominal wall with the fingers [ascites (abdominal fluid); hepatomegaly (enlargement of the liver)]
        • [Ascites: Fluctuation wave phenomenon. This can be triggered as follows: if one taps against one flank a wave of fluid is transmitted to the other flank, which can be felt by placing the hand on it (undulation phenomenon); flank attenuation
        • Meteorism (flatulence): hypersonoric tapping sound.
        • Attenuation of the tapping sound due to enlarged liver or spleen, tumor, urinary retention?
        • Hepatomegaly and/or splenomegaly: estimating liver and spleen size]]
      • Palpation (palpation) of the abdomen (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, renal bearing knocking pain?) [In advanced stages, the following symptoms may occur:
        • Ascites
        • Hepatomegaly
        • Palpable resistance in the upper abdomen]
  • Gynecologic examination [to exclude ovarian drip metastases (metastases (daughter tumors) arising in body cavities (in this case, abdomen/pelvic cavity) by caudal migration (toward the lower end of the body) of detached tumor cells with gravity on other organs or organ parts (in this case, ovaries/ovaries))/(Kruckenberg tumor)]
  • Health check (as an additional follow-up measure).

Square brackets [ ] indicate possible pathological (pathological) physical findings.